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What does diaper rash look like?
If your child's diaper area looks irritated and red, chances are it's diaper rash. The skin may also be a little puffy and feel warm when you touch it. Diaper rash can be mild, with just a few prickly red spots in a small area, or extensive, with tender red bumps that spread to your child's tummy and thighs.
Most parents have to deal with diaper rash at some point, especially in the first year or so of their child's life.
How did my child get diaper rash?
Diaper rash can be caused by anything from your child's own urine to a new food. Here are the most likely culprits:
- Wetness. Even the most absorbent diaper leaves some moisture on your child's skin. And when your child's urine mixes with bacteria from his stool, it breaks down into ammonia, which can be very harsh on the skin. That's why children with frequent bowel movements or diarrhea are more prone to diaper rash.
© Dr. P. Marazzi / Science Source
Although a child left in a wet or soiled diaper for too long is more likely to develop diaper rash, any child with sensitive skin can get a rash, even if you're diligent about diaper changes.
- Chafing and chemical sensitivity. Your child's diaper rash may be the result of his diaper rubbing against his skin, especially if he's sensitive to chemicals, like the fragrances in a disposable diaper or the laundry detergent used to wash a cloth diaper. It could also be that a product you're using during diaper changes irritates your child's skin.
- New foods. Diaper rash is also common when your child first starts eating solid foods or tries a new food. Any new food changes the composition of the stool, but the acids in certain foods (such as strawberries and fruit juices) can be especially troublesome for some kids. A new food also might increase the frequency of your child's bowel movements. If you're breastfeeding, your child could even be having a reaction to something you ate (although breastfed children are usually less likely to get a diaper rash).
- Bacterial or yeast infection. The diaper area is warm and moist – just the way bacteria and yeast like it. So it's easy for a bacterial or yeast infection to flourish there and cause a rash, especially in the cracks and folds of your child's skin. (Thrush is a type of oral yeast infection. Some children with thrush develop a yeast infection in their diaper area, too.)
- Antibiotics. Children taking antibiotics (or children whose breastfeeding mothers are on antibiotics) sometimes get yeast infections because these drugs kill the healthy bacteria that keep yeast in check as well as the harmful bacteria that's causing the illness. Antibiotics can also cause diarrhea, which can contribute to diaper rash.
When should I take my child to a doctor for diaper rash?
With some diligence, you should be able to clear your child's rash in three or four days without a visit to the doctor. But do see the doctor if the rash looks as though it may be infected. Signs of infection include:
- Pus-filled pimples
- Oozing yellow patches
- Open sores
The doctor may prescribe a topical or oral antibiotic for your child.
For a diaper rash caused by a yeast infection, your child's doctor may recommend an over-the-counter or prescription antifungal cream or ointment.
Also call the doctor if your child develops a fever or her rash doesn't go away after several days of home treatment.
What's the best way to treat diaper rash?
If diaper rash develops, take these steps to heal your child's skin:
- Keep your child clean and dry by changing his diaper frequently. That may mean getting him up at night for a diaper change
- Rinse his diaper area well at each diaper change. Don't use wipes that contain alcohol or fragrance. Some parents keep cotton balls and a squirt bottle or an insulated container of warm water at the changing table for easy, gentle cleanups.
- Pat your child's skin dry. Don't rub!
- Use an ointment that forms a barrier on the skin to protect your child's irritated skin from stool and urine. You don't have to use ointment at each diaper change: Apply a layer that's thick enough to last through a couple diaper changes. This helps prevent further skin irritation from too much rubbing. There are several good barrier ointments available that include petroleum jelly or zinc oxide.
- Put your child's diaper on loosely, or use a diaper that's a little big on him to allow for better air circulation. If you buy disposables, try a different brand to see if that helps. There are varieties for sensitive skin, for example, and extra-absorbent options pull more moisture away from your child's skin.
- When the weather is warm and your child can play outside, leave his diaper (and ointment) off for as long as possible every day. Exposure to the air will speed healing.
- Consider letting your child sleep with a bare bottom whenever he has a rash. A plastic sheet under the cloth one helps protect the mattress.
How can I prevent diaper rash?
Here are some good preventive measures to keep diaper rash at bay:
- A dry bottom is the best defense against diaper rash, so change your child's diaper frequently or as soon as possible after it becomes wet or soiled.
- Clean your child's genital area thoroughly with each diaper change.
- Pat her skin dry – never rub it. You can also use a hair dryer set on low to dry the diaper area after a diaper change.
- If your child seems prone to diaper rash, spread a thin layer of protective ointment on her bottom after each diaper change.
- Don't use powders or cornstarch because the particles can be harmful to a child's lungs if inhaled. Also, some experts think cornstarch can make a yeast diaper rash worse.
- When your child starts eating solid foods, introduce one item at a time. Waiting a few days between each new food makes it easier to determine whether a sensitivity to a new food is causing diaper rash. If it is, eliminate that food for the time being.
- Don't secure the diaper so tightly that there's no room for air to circulate. Dress her in loose clothing.
- Use fragrance-free detergent to wash cloth diapers, and skip the fabric softener – both can irritate your child's skin.
- Wash diapers with hot water, and double rinse them. You also might add a half cup of vinegar to the first rinse to eliminate alkaline irritants.
- Breastfeed your child for as long as you can because diaper rash occurs less often in breastfed babies, although it isn't completely clear why.
- When your child does need to take an antibiotic, ask the doctor about giving her a probiotic as well. Probiotics encourage the growth of healthy bacteria in the gut, which may reduce your child's chances of getting a diaper rash.
- If your child goes to daycare or preschool, make sure that her caregivers understand the importance of taking these precautions.